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NURS 3800 > Newborn transition Assessment > Flashcards

Newborn transition Assessment Flashcards

0
Q

What causes the change from fetal to neonatal circulation

A

Cessation of blood through the umbilical vessels and placenta

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1
Q

How long can it take to transition from intrauterine to extrauterine life?

A

Up to 12 hours

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2
Q

Fetal to neonatal circulation occurs simultaneously with what

A

Respiratory adaption

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3
Q

When do the ductus venosus, foramen oval and the ductus ateriousus usually close

A

Within the first 24 hours of life

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4
Q

What happens with cardiovascular adaption

A

Closure of the ductus venosus, foramen ovals and the ductus arteriousus
Shift to pulmonary circulation

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5
Q

How long do you count apical impulse in a newborn

A

Full minute

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6
Q

Where is PMI in a newborn

A

4th ICS to the left of the MCL

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7
Q

Normal heart rate at birth

A

120-160

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8
Q

In utero what’s a normal heart rate

A

Same as at birth. 120-160

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9
Q

Normal capillary refill in a neonatal

A

Less than 3 seconds

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10
Q

Average systolic and diastolic BP

A

60-80/40-50

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11
Q

Why are femoral and bracial pulses palpated in neonatal

A

For symmetry, strength, and rate to provide info about change to adult circulation patterns

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12
Q

Where do you palpate femoral pulse? Brachial?

A

Femoral- groin

Brachial? Inside of arm

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13
Q

Why do you check both femoral and brachial pulse in neonatal

A

Coarctation of aorta

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14
Q

Average blood volume in neonatal

A

300 ml

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15
Q

What can late clamping of the cord lead to

A

Polycythemia

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16
Q

Normal hemoglobin level in neonatal

A

14-24 g/dl

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17
Q

Normal hematocrit in a neonatal

A

44%-64%

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18
Q

Normal RBC in neonatal

A

4.8-7.1 /mm

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19
Q

Normal WBC in neonatal

A

9,000-30,000 per mm

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20
Q

Average platelets in neonatal

A

200,000-300,000

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21
Q

What are the clotting factors

A

Factor II, VII, IX, and X

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22
Q

Why are clotting factors low in neonatal

A

Lack of vitamin K

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23
Q

If all the clotting factors are low at birth what could happen

A

Risk for bleeding

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24
Q

Breathing can be noted as early as ____ weeks gestation

A

11 weeks

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25
Q

Functioning lungs occurs after ____ weeks gestation

A

26

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26
Q

When is surfactant found in sufficient quantity

A

Around 35 weeks gestation

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27
Q

Fetal lung fluid is necessary for development does it increase or decrease with gestational age

A

It decreases

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28
Q

What helps with the surface tension in lungs

A

Surfactant

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29
Q

What could low amniotic fluid level mean

A

Could mean kidneys are not working correctly. Amniotic fluid stays in normal range by peeing so this would show kidneys are working

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30
Q

What does catecholamines do?

A

Increases the release of surfactant

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31
Q

Catecholamine surge prior to labor corresponds to what

A

Rapid drop in level of fluid in lung field

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32
Q

What stimulates the aortic and carotid chemoreceptors triggering the medulla initiation of receptors

A

Decrease oxygen and increase carbon dioxide concentration along with decrease pH

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33
Q

Surfactant increases the lungs ability to do what?

A

Fill with air

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34
Q

How does surfactant promote lung expansion

A

By preventing the complete collapsing of the alveoli with each expiration

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35
Q

Compression of the chest during vaginal birth forces ___of the fluid out of the lung fields

A

1/3

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36
Q

How does crying keep the alveoli open?

A

Creates positive intrathoracic pressure

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37
Q

What are three examples of sensory stimulation

A

Tactile
Visual
Auditory

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38
Q

Is there fluid in the lungs until the baby is born?

A

Yes

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39
Q

When does pulmonary vasodilation occur

A

As oxygen enters the lungs

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40
Q

What kind of sign is grunting after birth

A

Never a good sign

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41
Q

Respiratory adaptions are established within _____ after birth

A

1 minute

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42
Q

Babies are ____ breathers

A

Nose

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43
Q

Normal respirations for neonate

A

30-60 per minute

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44
Q

How should you count respirations

A

For a full minute because they may be irregular

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45
Q

Respirations should be noisy?

A

No they should be quiet

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46
Q

What does a baby use to breathe

A

Diaphragmatic and abdominal muscles

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47
Q

What are signs of respiratory distress

A

Nasal flaring, grunting, costal retractions and a rate less than 30 or more than 60

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48
Q

What is newborns ability to Maintain its temperature controlled by

A

External environmental factors and internal physiologic process

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49
Q

Heat loss as water evaporates from the skin

A

Evaporation

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50
Q

Transfer of body heat to surrounding air ( cold delivery room)

A

Convection

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51
Q

Transfer of heat to surface newborn is lying on

A

Conduction

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52
Q

Loss of heat through the air to a cooler surface (not in direct contact with the neonate)

A

Radiation

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53
Q

What do neonates have limited ability to do in order to generate heat?

A

Shiver

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54
Q

How is heat produced?

A

By the metabolism of brown fat and babies have less brown fat

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55
Q

Flexion of extremities, restlessness, and crying are examples of what

A

Voluntary muscle activity which is a thermogenic adaption

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56
Q

With cold stress, Increase glucose utilizes leads to?

A

Hypoglycemia

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57
Q

With cold stress, Increase oxygen consumption can lead to?

A

Metabolic acidosis

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58
Q

Signs of cold stress/hypothermia

A

Skin cool to touch, mottling of the skin, central cyanosis, decreased responsiveness, jittery, tachypnea

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59
Q

How is glucose stored for neonatal metabolic demands

A

Glucose is stored as glycogen

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60
Q

Due to rapid depletion of glycogen during the first 24 hours the glucose level will be between what ?

A

50-60 mg/ml

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61
Q

In utero _____ is stored for use in hemoglobin production after birth. If adequate will last till ____ month without needing supplement

A

Iron

5th

62
Q

Will you hear bowel sounds as soon as baby is born?

A

No. Audible bowel sounds will be within first hour

63
Q

Stomach capacity in neonate

A

30-90 ml

About 3 oz

64
Q

When is first meconium passed

A

12-24 hours

65
Q

What could cause pink staining in diapers

A

Uris crystals

66
Q

How long will,it take renal system to fully mature

A

1 year

67
Q

____ ml of urine at birth

A

40

68
Q

___-___ voids per day for first 2 days

A

2-6

69
Q

___-____ voids per day after 48 hours

A

5-25

70
Q

___-___ ml of urine per/kg/day

A

15-60

71
Q

Color of urine

A

Odorless straw color

72
Q

When do you start immunizations?

A

8 weeks

73
Q

What three immunoglobulins does neonate depend on

A

IgA, IgG, IgM

74
Q

Steps in initial assessment

A 
Apgar score determined
Assess for gross abnormalities
Apply cord clamp
Obtain foot prints
Apply identification bands
Administer Vit K and eye prophylaxis 
Promote bonding
75
Q

How long is the first period of reactivity

A

Birth to 30 minutes

76
Q

Heart rate in first period of reactivity

A

160-180 bpm

77
Q

Respiratory rate in first period of reactivity

A

60-80

Crackles may be present

78
Q

After the first period of reactivity how long may the newborn sleep

A

60-100 minutes

79
Q

How long is the transition second period

A

4-8 hours

80
Q

Brief periods of what may happen in transition second period

A

Tachycardia and tachypnea, usually last only 10 minutes

81
Q

Average newborn length

A

19 to 21 inches

82
Q

Average newborn weight

A

7 pounds 8 ounces

83
Q

SGA baby weight

A

Less than 5 pounds 8 ounces ( less than 10%)

84
Q

LGA baby weight

A

Greater than 9 pounds ( greater than 90%)

85
Q

Newborns can loose up to ___% of birth weight

A

10%

86
Q

Normal newborn head circumference

A

33-38 cm

87
Q

Normal newborn chest circumference

A

31-36 cm

88
Q

A LGA baby may have a hard time doing what

A

Maintaining glucose

89
Q

A SGA baby may have a hard time doing what

A

Maintaining temperature

90
Q

Normal axillary temperature in newborn

A

97-99.5 degrees F

91
Q

What kinds of breathers are newborns

A

Nose breathers

92
Q

What respiratory patterns should you observe newborns for

A

Flaring, grunting, retracting

93
Q

What should you ascultate newborns for? This is not an ok finding

A

Rales

94
Q

What shape is anterior fontanel? When does it close?

A

Diamond shaped closes in 18 months

95
Q

What shape is posterior fontanel? When does in close?

A

Triangle shaped and closes in 8-12 weeks

96
Q

How should fontanels be

A

Open and soft

97
Q

What do depressed fontanels indicate

A

Dehydration

98
Q

What do bulging fontanels indicate

A

May be increased intracranial pressure

99
Q

What colors are eyes? When does a permanent color establish?

A

Usually blue or gray. Permanent color establishes in 3-12 months

100
Q

If red reflex is present what is intact

A

Cornea

101
Q

How far can newborns see? Where is clearest vision?

A

Up to 2 1/2 feet. Clearest vision 8-12 inches

102
Q

What may low set ears be a red flag for

A

Chromosomal abnormalities

103
Q

What could bell shaped chest be a sign of

A

Undeveloped lungs

104
Q

What shape should chest be

A

Cylindrical

105
Q

What could unequal breath sounds be

A

Pneumothorax

106
Q

What is present in umbilical cord

A

2 arteries, 1 vein

107
Q

What does flat abdomen indicate

A

Diaphragmatic hernia

108
Q

What is supra public area palpated for

A

Bladder distention

109
Q

What could not feeling femoral pulse be a sign of

A

Coarctation of the aorta

110
Q

In a term newborn what is normal for the female genital

A

Labia majora covers labia minora and clitoris

111
Q

Newborns may have mucoid vaginal discharge due to what

A

Maternal hormones

112
Q

How would you know if the anus is patent

A

If they have a stool

113
Q

Can a hymental tag be present in a newborn?

A

Yes

114
Q

When do testes descend?

A

By a year of Age

115
Q

What should you check with male genital assessment

A

Placement of meatus

116
Q

Is opening of penis is on dorsal surface

A

Epispadias

117
Q

If opening of penis is on ventral surface

A

Hypospadias

118
Q

What is present on scrotum

A

Rugae

119
Q

Hyperflexibility of joints is associated with what

A

Down Syndrome

120
Q

Test to assess for hip dislocation in newborns

A

Ortolani’s

121
Q

What do Simian creases suggest

A

Down syndrome

122
Q

What is dimpling associated with

A

Spina bifida

123
Q

What is normal sleep-wake cycle in newborns

A

45 minutes

124
Q

Most common sign of pain

A

Crying

125
Q

How can you tell intracranial pressure

A

By fontanel

126
Q

What does the AAP recommend about infants and breast feeding

A

That they are exclusively breast feed for first 6 months of life

127
Q

How long should breast feeding continue

A

At least 12 months

128
Q

If infants are weaned before 12 months from breast milk what should they receive

A

Iron-fortified infant formula

129
Q

Why is breast milk considered live tissue

A

Because it contains almost as many live cells as blood

130
Q

How many lobes are the female breasts composed of? Why are in these lobes?

A

15-20 lobes embedded in fat and connective tissue, well supplied with blood vessels, lymphatic vessels, and nerves

131
Q

How does the milk collect ebbing the nipple

A

Ductles enlarge into lactiferous ducts and sinuses

132
Q

How is milk transported to the sucking infant

A

Nipple has 15-20 pores through which milk is transferred

133
Q

How is prolactin produced

A

By infant sucking and emptying the breasts

134
Q

When is prolactin highest

A

First 10 days

135
Q

Do the breasts ever completely empty

A

No

136
Q

What is oxytocin

A

Another hormone essential to lactation

137
Q

What is colostrum

A

A clear yellowish fluid birth to 48 hours. It is more concentrated than mature milk

138
Q

What is colostrum extremely rich in

A

Immunoglobins

139
Q

When do you see transition milk? What are the characteristics?

A

48-72 hours

High levels of fats, lactose, and water soluble vitamins. Higher calorie content. Larger volume

140
Q

When is mature milk produced

A

By 10th to 15th day

141
Q

What is percentage of water in mature milk?

A

90% water. Remaining 10% carbohydrates, fats, and proteins. More water maintains newborns fluid balance

142
Q

What is the size of a newborns stomach? What about after 7-10 days?

A

Small marble can hold 5-7 cc’s . After 7-10 days in increases to the size of a golf ball and can hold 1.5 to 2 ounces

143
Q

How many times do newborns nurse in 24 hour time period

A

8-12 times

144
Q

How often do newborns give cues to feed

A

Every 1-3 hours

145
Q

What may result from poor latch on

A

Sore nipples

146
Q

What does plugged milk ducts result from

A

Inadequate emptying or underwire bra. You should apply warm compresses prior to nursing

147
Q

What is characterized by sudden flu like symptoms usually effects only one breast

A

Mastitis

148
Q

Small raised white spots on the nose, chin, and forehead

A

Milia

149
Q

Bluish purple spots of pigmentation. Commonly on shoulders, back, and buttocks

A

Mongolian spots

150
Q

Should the head or chest circumference be larger?

A

Head should be 2-3 cm larger than chest circumference

151
Q

Small whit nodules that appear on the roof of a newborns mouth

A

Epsteins pearls

152
Q

How is the Moro Reflex elicited

A

By holding the newborn in a semi sitting position and then allowing the head and trunk to fall backward

153
Q

Crackles and wheezing are symptoms of what

A

Fluid or infection In the lungs

NURS 3800 (19 decks)

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